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Pathology > Session 2 - Inflammation > Flashcards

Session 2 - Inflammation Flashcards

1
Q

this is known as the body’s reaction to tissue injury or infection characterized by reddening, pain, swelling, and warmth.

A

inflammation

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2
Q

what is the warmth that is associated with inflammation due to?

A

increased blood flow (and dilation) to the traumatized site

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3
Q

symptoms of swelling, heat and pain resulting from dilation of the BV in the affected part is associated with what in terms of plasma and WBC?

A

loss of plasma and wbc into the tissues –> this is what causes the swelling

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4
Q

how do wbc communicate with one another?

A

via cytokines

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5
Q

what is the first initial process of inflammation? (in terms of the BV)

A

bref contraction of nearby arterioles - remember, this is followed by dilation which involves flushing of the capillaries with blood, from which plasma proteins and wbc pass into injured tissues causing swelling as they attack the cause of injury

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6
Q

in terms of inflammation, amplification depends on what?

A

the extent of injury and the activation of mediators

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7
Q

termination of the inflammatory response is mediated by what?

A

intrinsic anti-inflammatory mechanisms that limit tissue damage.

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8
Q

T or R: the inflammatory process may stimulate nerves and cause pain

A

true

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9
Q

what is the main wbc involved in ACUTE inflammation?

A

PMNs (polymorphonuclear neutrophils)

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10
Q

what is the main wbc involved in CHRONIC inflammation?

A

lymphocytes and few macrophages

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11
Q

what is the condition of increased blood flow to the tissues called?

A

hyperemia (remember, this is responsible for redness and warmth at sites of tissue injury).

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12
Q

what is the real impetus for edema after inflammation? (think in terms of the cell)

A

increase in endothelial cell barrier permeability results in the edema

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13
Q

how is the extravascular fluid cleared post inflammation?

A

cleared through the lymphatics

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14
Q

this is known as the accumulation of fluid within the extravascular compartment and interstitial tissues

A

edema

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15
Q

edema fluid with low protein content (specific gravity <1.015)

A

transudate

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16
Q

which type of edema fluid tends to occur in noninflammatory conditions, where the the endothelial barrier remains intact and prevents loss of large molecules from the vasculature?

A

transudate

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17
Q

edema fluid with high protein concentration which frequently contains inflammatory cells.

A

exudate

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18
Q

which type of edema fluid is produced by mild injury such as sunburn or traumatic blisters?

A

exudate

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19
Q

this type of exudate contains large amounts of fibrin as a result of activation of the coagulation system.

A

fibrinous exudate

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20
Q

this type of exudate/effusion contains prominent cellular components (PMNs) and is frequently associated with pathological conditions such as pyogenic bacterial infections.

A

purulent

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21
Q

T or F: vasoactive mediators originate from both plasma and cellular sources and are generated at sites of tissue injury

A

TRUE - remember, these bind to receptors and can cause v/d or v/c.

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22
Q

in terms of the vascular response, proximal to capillaries, what happens to the arterioles?

A

v/d to increase BF

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23
Q

in terms of the vascular response, distally, what happens to the venules?

A

v/c which increases capillary bed hydrostatic pressure potentiating edema formation

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24
Q

with severe direct injury, what does the cell body form?

A

blebs

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25
Q

is it the capillary or venous side (in terms of the microcirculatory environment) that interacts with clotting mechanisms and the overall inflammation process?

A

capillary venous side

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26
Q

what are the 2 main sources of plasma-derived inflammatory mediators of increased vascular permeability?

A

Factor XII (Hangeman factor, which includes the clotting/fibrinolytic system and the Kallkerin-kinin system) and complement system (C3a, C5a)

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27
Q

in terms of cell-derived sources of inflammatory mediators, they include: mast cells, inflammatory cells, and what two other sources?

A

platelets and endothelium; mast cells are associated with histamine; platelets with serotonin; inflammatory cells with leukotrienes, PAF and prostaglandins, and endothelium with nitric oxide, PAF, and prostaglandins

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28
Q

what are the other two respective names for local and systemic mediators?

A

cell and plasma-derived

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29
Q

what is the end point of the complement system?

A

formation of MAC (membrane attack complex)

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30
Q

what makes the process of phagocytosis easier?

A

opsonins (esp C3b)

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31
Q

what is the classic pathway activated by?

A

Ag-Ab complex -proteins includd c1 to c9

32
Q

in terms of arachidonic acid metabolism, the pathway that involves 5-lipoxygenase leads to what?

A

leukotrienes

33
Q

in terms of arachidonic acid metabolism, the pathway that involves cyclooxygenase leads to what? (it’s a 2 tiered approach)

A

PGH2 and then Prostaglandins and thromboxanes.

34
Q

in terms of eicosanoids, phospholipases are inhibited by what?

A

steroids

35
Q

cyclooxygenase is inhibited by what?

A

COX1 an COX2 inhibitors

36
Q

what are two of the most common COX inhibitors

A

aspirin and indomethicin

37
Q

leukotrienes mainly cause v/c or v/d?

A

v/c and also bronchospasm; as a side note it also causes increased permeability

38
Q

prostacylins mainly cause v/d or v/c? how does it affect platelet aggregation?

A

v/d and also it inhibits platelet aggregation

39
Q

thromboxanes cause v/d or v/c? how does it affect platelet aggregation?

A

v/c and promotes plate aggregation

40
Q

in terms of leukocyte interaction with endothelial selections what is the interaction that involves the slowing of leukocytes in the BF?

A

tethering

41
Q

leukocytes moving along the vascular endothelial cell surface with saltatory movement is known was what?

A

rolling

42
Q

PMNS become activated by proximity to the endothelium and by inflammatory mediators. when this happens, they adhere strongly (firm adhesion) to intercellular adhesion molecules on the endothelium - what is this called?

A

leukocyte arrest

43
Q

in terms of leukocyte action in the inflammatory process, endothelial cells separate, and leukocytes do what?

A

transmigrate through the vessel wall, and under the influence of chemotactic factors, they migrate through extravascular tissue to the site of injury

44
Q

MAKE SURE YOU KNOW THE STEPS IN THE INFLAMMATORY PROCESS

A

KNOW THEM!! - Check packets

45
Q

what is known as directed cell migration?

A

chemotaxis - remember it is a combination of attractants, replants, and adhesion molecules

46
Q

what is one of the more important chemotactic factors?

A

C5a

47
Q

what are the 4 molecular families of adhesion molecules that are involved in leukocyte recruitment?

A

selectins, addressins, integrins, member of the immunoglobulin family

48
Q

T or F: blood leukocytes are recruited by chemoattractants released by endothelial cells; they then migrate from the endothelium toward the targeted tissue up a several chemoattractant gradients.

A

FALSE - all is correct except the leukocytes move DOWN the gradient

49
Q

when leukocytes transverse the endothelial barrier how do they move? (IOW, what is the term used to describe their migration?)

A

PARAcellular diapedesis (passing btwn adjacent endothelial cells)

50
Q

how do neutrophils migrate through endothelial cells? IOW, what is the term used to describe their migration?

A

TRANScellular diapedesis

51
Q

PMNs transverse thin regions of the endothelium called what?

A

fenestrae

52
Q

in the digestion phase of the intracellular events of inflammation, when the phagosome that contains the foreign material fuses with cytoplasmic lysosomes, what is it called?

A

phagolysosome (lysosomal enzymes are released into this)

53
Q

what are the four steps involved in the intracellular events of inflammation?

A

recognition, signally, internalization, and digestion

54
Q

this is known as a shift of water from the vascular space into another compartment, usually the interstitial compartment

A

edema

55
Q

occurs when there is venous pressure (hydrostatic edema) or low plasma osmotic pressure

A

low protein edema aka transudate

56
Q

a type of low protein edema; occurs when plasma albumin levels are abnormally low allowing water to escape from the vascular space into the interstitial space. also, this type of edema is typically associated with what disease process?

A

osmotic edema; liver disease (b/c remember, the liver is the primary producer of albumin)

57
Q

what is the term for generalized edema?

A

anasarca

58
Q

what type of edema is due to obstructed lymphatics?

A

lymphedema

59
Q

T or F: inflammatory cells have oxidative activity that leads to the production of several oxygen metabolites which are more reactive than oxygen itself. .

A

true. these contribute to killing of ingested bacteria

60
Q

T or F: Lysosomal acid hydrolases and specialized noncatalytic proteins unique to inflammatory cells are examples of nonoxidative bacterial killing

A

true

61
Q

T or F: since neutrophils have a short life-span, acute inflammatory rns are usually self-limited.

A

TRUE - typically followed by restoration of normal tissue architecture and function (resolution)

62
Q

this is the term to describe what happens if a tissue is irreversibly injured

A

scar

63
Q

if the area of acute inflammation is walled off by inflammatory cells and fibrosis, PMN products destroy the tissue and form this.

A

abscess

64
Q

localized acute inflammation and chronic inflammation may cause secondary inflammation of lymphatic channels and nodes. the lymphs will show hyperplasia

A

lymphadenitis

65
Q

this is the term used to describe the failure to eliminate a pathological insult or inability to trigger resolution to inury.

A

persistent inflammation

66
Q

when inflammatory cells persist, how does the stroma react?

A

it becomes hyperplastic –> if it continues it can lead to tissue destruction and may lead to organ dysfunction

67
Q

regarding the events of chronic inflammation: these are the microbial products or injury, and initiate the response

A

specific tirggers

68
Q

regarding the events of chronic inflammation: direct recruitment, activation, and interaction of inflammatory cells are done by which player?

A

chemical mediators

69
Q

once there is stromal cell activation and extracellular matrix what is happening in the inflammatory process?

A

remodeling.

70
Q

T or F: chronic inflammation is synonymous with chronic infection

A

FALSE; it can be associated with such things as cancer, and trauma.

71
Q

this is a protective response to chronic infection.

A

granulomatous inflammation

72
Q

what are the principal cells involved in granulomatous inflammation?

A

macrophages and lymphocytes

73
Q

under certain conditions, local injury may result in prominent systemic effects. what is the most serious of these possible effects ?

A

systemic inflammatory response syndrome

74
Q

what is systemic inflammatory response syndrome characterized by? (3 main things)

A

leukocytosis, fever and shock

75
Q

what is the clinical hallmark of inflammation?

A

fever

Pathology (8 decks)

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